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Change in Pain Severity With Open Label Venlafaxine Use in Patients With a Depressive Symptomatology: An Observational Study in Primary Care

Published online by Cambridge University Press:  06 March 2008

Stefan Begré ,
Martin Traber ,
Martin Gerber  and
Roland von Känel
Stefan Begré*
Affiliation:
Department of General Internal Medicine, Division of Psychosomatic Medicine, University Hospital/Inselspital, CH-3010Bern, Switzerland
Martin Traber
Affiliation:
Wyeth Pharmaceuticals AG, Grafenauweg 10, CH-6301Zug, Switzerland
Martin Gerber
Affiliation:
GEM Clinical Research Consulting M. Gerber, Gewerbestrasse 6, CH-6314Unterägeri/ZG, Switzerland
Roland von Känel
Affiliation:
Department of General Internal Medicine, Division of Psychosomatic Medicine, University Hospital/Inselspital, CH-3010Bern, Switzerland
*
∗Corresponding author. Tel.: +41 31 632 20 19; fax: +41 31 382 11 84. E-mail addresses: stefan.begre@insel.ch (S. Begré), traberm@wyeth.com (M. Traber), mail@gem-crc.ch (M. Gerber), roland.vonkaenel@insel.ch (R. von Känel).
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Abstract

Purpose.

Venlafaxine has shown benefit in the treatment of depression and pain. Worldwide data are extensively lacking investigating the outcome of chronic pain patients with depressive symptoms treated by venlafaxine in the primary care setting. This observational study aimed to elucidate the efficacy of venlafaxine and its prescription by Swiss primary care physicians and psychiatrists in patients with chronic pain and depressive symptomatology.

Subjects and methods.

We studied 505 patients with depressive symptoms suffering from chronic pain in a prospective naturalistic Swiss community based observational trial with venlafaxine in primary care. These patients have been treated with venlafaxine by 122 physicians, namely psychiatrists, general practitioners, and internists.

Results.

On average, patients were treated with 143 ± 75 mg (0–450 mg) venlafaxine daily for a follow-up of three months. Venlafaxine proved to be beneficial in the treatment of both depressive symptoms and chronic pain.

Discussion.

Although side effects were absent in most patients, physicians might have frequently omitted satisfactory response rate of depression by underdosing venlafaxine. Our results reflect the complexity in the treatment of chronic pain in patients with depressive symptoms in primary care.

Conclusion.

Further randomized dose-finding studies are needed to learn more about the appropriate dosage in treating depression and comorbid pain with venlafaxine.

Keywords

PainUnipolar depressionAntidepressantPsychiatry in EuropeSwitzerlandPrimary careVenlafaxineClinical care
Type
Original article
Information
European Psychiatry , Volume 23 , Issue 3 , April 2008 , pp. 178 - 186
Copyright
Copyright © European Psychiatric Association 2008

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Footnotes

1

Tel.: +41 41 729 03 21; fax: +41 41 729 03 03.

2

Tel.: +41 31 632 20 19; fax: +41 31 382 11 84.

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